Letter to James Peake, Secretary of Veterans Affairs

Letter

U.S. Senator Barack Obama today sent the following letter to Secretary of Veterans Affairs James Peake, calling on him to investigate reports that a psychologist at a Texas Veterans Affairs (VA) facility told staff members to refrain from diagnosing veterans with post-traumatic stress disorder (PTSD) in order to reduce costs. According to today's Washington Post, the psychologist, Ms. Norma Perez, apparently emailed Teague Center staff members suggesting the alternative diagnosis to limit the number of tests required to diagnose PTSD. Since the wars in Iraq and Afghanistan began, thousands of service members have returned home suffering from combat-related psychological injuries like PTSD, which require much-needed treatment.

In the letter, Obama calls on Peake to launch an investigation into the incident to evaluate whether Perez was advised to send this e-mail or give this instruction at the urging of her superiors; whether staff members at the Teague Center followed Perez's advice, and if so, how many veterans were affected by incorrect diagnoses; whether officials at other veterans centers have given some similar admonitions to staff members charged with diagnosing PTSD; whether affected veterans have been given immediate re-diagnoses and; whether this is an incident or a trend through the VA system.

Obama also wrote today to Veterans Affairs' Committee Chairman Daniel Akaka requesting a hearing to examine this matter.

The text of the letter is below:

Dear Secretary Peake:

I am writing to express my serious concerns about reports that a psychologist at a Texas Veterans Affairs (VA) facility told staff members to refrain from diagnosing veterans with post-traumatic stress disorder (PTSD).

According to today's Washington Post, Norma Perez, a psychologist at the Department of Veterans Affairs' Olin E. Teague Veterans' Center in Temple, Texas, sent an email to other staffers saying: "Given that we are having more and more compensation seeking veterans, I'd like to suggest that you refrain from giving a diagnosis of PTSD straight out." She then suggested the alternative diagnosis of "Adjustment Disorder," adding that VA staff members "really don't . . . have time to do the extensive testing that should be done to determine PTSD."

Simply put, Ms. Perez's email is outrageous. As you well know, PTSD is the most prevalent mental disorder afflicting our returning Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) veterans. In order to receive their deserved benefits, these brave men and women must endure a long and arduous process. To hear that a VA official is promoting misdiagnoses of soldiers to save money is unacceptable and is tantamount to fraud.

You have said that Ms. Perez's email is "inappropriate," but more must be done. I call on the Department to open an investigation into the following:

1) Whether Ms. Perez was advised to send this e-mail or give this instruction at the urging of her superiors at the Teague Center.

2) Whether staff members at the Teague Center followed Ms. Perez's advice, and if so, how many veterans were affected by incorrect diagnoses.

3) Whether officials at other veterans centers have given some similar admonitions to staff members charged with diagnosing PTSD.

4) Whether this is an incident or a trend. I understand that the VA keeps detailed information on the number of diagnoses of PTSD and adjustment disorder. Your investigation must look at changes in the number of both diagnoses over time, both system-wide and on a facility-by-facility basis.

5) What is being done to ensure that any veterans affected by this instruction do not fall through the cracks. All veterans given an incorrect diagnosis should be given redress both in their diagnoses and their subsequent disability benefits.

6) Whether there are any trends among veterans who have committed suicide recently to determine whether any were wrongly diagnosed with adjustment disorder. Your investigation should include a survey of root cause analyses of recent veteran suicides.

7) Whether there are other instances across the VA bureaucracy of veterans with legitimate cases of PTSD being swept under the rug for budgetary reasons or for expediency. Why, for instance is the number of approved benefits claims for PTSD at the Veterans Benefits Administration decreasing at a time when diagnoses for PTSD at the Veterans Health Administration are increasing?

Too many veterans see the VA as a bureaucracy with the singular goal of denying services and benefits to veterans. This recent incident merely serves to promote that impression. I request that you advise me by no later than Friday, May 23, 2008, as to whether you will open such investigation.